HEENT Assessment

Question 1

What percentage of anomalies seen at birth occur in the HEENT region?

Answer 1

90%

This emphasizes the importance of thorough HEENT assessments in newborns.

Question 2

What techniques are required for HEENT assessment?

Answer 2

• Observation/visualization
• Measurements
• Palpation
• Use of ophthalmoscope
• Auscultation
• Inspection

Question 3

What is the average occipital-frontal circumference (OFC) at term?

Answer 3

35 cm

The range is 33 – 37 cm for 10% - 90% of infants.

Question 4

What does microcephaly indicate in terms of occipital-frontal circumference?

Answer 4

OFC < 3%

It suggests poor brain growth or inaccurate dating.

Question 5

What does macrocephaly indicate in terms of occipital-frontal circumference?

Answer 5

OFC > 90%

It can be familial or related to conditions like hydrocephalus.

Question 6

What are the characteristics of the anterior fontanel?

Answer 6

• Intersection of metopic, coronal, and sagittal sutures
• Average size: 0.6 – 3.6 cm across
• Should be flat and soft; sunken indicates dehydration; bulging indicates increased intracranial pressure.

Question 7

What is craniosynostosis?

Answer 7

Premature closure of a suture line

It may lead to various head shapes such as plagiocephaly or scaphocephaly.

Question 8

What is the significance of palpating sutures in newborns?

Answer 8

To assess mobility of sutures and detect conditions like increased intracranial pressure.

Question 9

What does craniotabes refer to?

Answer 9

Soft or thin areas of bone that collapse when pressed

It may indicate increased pressure from the fetal head.

Question 10

What is caput succedaneum?

Answer 10

Scalp edema across suture lines with poorly defined edges that resolves within days.

Question 11

What distinguishes cephalohematoma from caput succedaneum?

Answer 11

Cephalohematoma does not cross suture lines and can enlarge over the first few days.

Question 12

What is subgaleal hemorrhage?

Answer 12

Bleeding between the galea aponeurosis and skull periosteum that can extend to the neck.

Question 13

What are Epstein pearls?

Answer 13

Small yellow or white papules that are epithelial inclusion cysts and disappear by a few weeks of age.

Question 14

What is the most common neck mass in infants?

Answer 14

Cystic hygroma

It results from the development of sequestered lymph channels.

Question 15

What does the presence of facial nerve palsy indicate?

Answer 15

Peripheral nerve compression presenting soon after birth with decreased movement on the affected side.

Question 16

What is the typical presentation of congenital cataract?

Answer 16

White reflex in the eye indicating abnormalities such as glaucoma or tumors.

Question 17

What is the purpose of assessing the nasolacrimal duct?

Answer 17

To check for obstruction which is common and usually resolves spontaneously.

Question 18

What does macroglossia indicate?

Answer 18

Conditions such as Beckwith-Wiedemann syndrome or hypothyroidism.

Question 19

What is ankyloglossia?

Answer 19

Tongue-tie occurring in approximately 4% of newborns

Most babies can breastfeed without difficulty despite this condition.

Question 20

What is the significance of assessing the external ear?

Answer 20

To identify anomalies and ensure the ear canal is patent.

Question 21

What is hypospadias?

Answer 21

A condition where the urethral opening is not located at the tip of the penis.

Question 22

What is the expected reaction of pupils to light in a normal infant?

Answer 22

Pupils should be equal and react to light.